There is no question that an aggravation of a pre-existing condition is considered a new injury in Pennsylvania, and can be the basis for an award of workers’ comp benefits. However, a dispute which can arise in these kinds of cases is whether ongoing effects or limitations are from the pre-existing condition alone, or from the consequences of the work injury.
In 1998, the Supreme Court of Pennsylvania issued a decision in the matter of Bethlehem Steel Corporation v. Workmen's Compensation Appeal Board (Baxter). Here, the injured worker had been previously diagnosed with asthma. Then, while exposed to paint fumes at work, he had an aggravation of the asthma. Once he was away from the paint fumes, his lung functions returned to normal and he had no restriction or limitation.
The injured worker was awarded benefits, but only until he had returned to his “baseline” medical condition (as he had been before the work-related aggravation). At that point, said the Court, he became ineligible for workers’ compensation benefits (even though he remained unable to go back to that workplace).
With all of this in mind, the Commonwealth Court of Pennsylvania recently addressed this issue in Little v. Workers' Compensation Appeal Board (Select Specialty Hospital). Here, the injured worker was a nurse, who developed occupational asthma as a result of being exposed to a specific type of floor wax being used at the facility in which she worked. As in the Baxter case, away from this floor wax, the injured worker had no limitations or restrictions. As in the Baxter case, finding another job had led to a decrease in her earnings. Would she fare as poorly as Mr. Baxter?
The Workers’ Compensation Judge (WCJ) awarded workers’ comp benefits only to the date the “Independent” (I use that term mostly for amusement, considering physicians hired by the insurance carrier are often anything but) Medical Examiner (IME) said that the injured worker’s condition had completely resolved. As in Baxter, as long as she stayed away from the specific irritant (that floor wax), she was under no restriction. The Workers’ Compensation Appeal Board (WCAB) affirmed, noting that the IME had credibly testified that she fully recovered from her work injury without any residual pulmonary impairment or disability.
But, unlike in Baxter, the injured worker here prevailed with the Commonwealth Court of Pennsylvania, who reversed the decision of the WCJ. The difference? In Baxter, the injured worker already had asthma before the work injury; the injury was an aggravation of a pre-existing condition. Here, though, the injured worker never before had asthma. The injury was occupationally induced asthma (not an aggravation at all, but an entirely new injury). Specifically, the Court concluded:
“Regardless of whether the Claimant lacks current pulmonary symptoms or does not need current treatment, these are residual medical conditions that Claimant did not have prior to her employment with (her employer). Consequently, we hold that the WCJ’s determination that Claimant fully recovered from her work injury without any residual impairment is contrary to the credited evidence of record and is erroneous as a matter of law. Claimant’s medical experts and IME Physician agreed that Claimant developed allergic asthma and cannot return to her pre-injury work environment as a result of her cumulative occupational exposure to Di-Isocyanate. Therefore, the WCJ erred in terminating Claimant’s benefits as of IME Physician’s February 2011 examination.”